What is the treatment for paronychia (infection around the nail bed)?

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From the Guidelines

To treat pus around a nail bed, it is essential to start with soaking the affected finger in warm water with Epsom salt for 15 minutes, 3-4 times daily, as this helps reduce inflammation and draw out pus. This initial step is crucial in managing the infection and should be followed by gently drying the area and applying an antibiotic ointment like Neosporin or Polysporin, then covering with a clean bandage 1.

When considering the treatment options, it's vital to differentiate between various conditions that may mimic the symptoms of pus around the nail bed, such as onychomycosis, candidosis, or bacterial infections, as mentioned in the guidelines by the British Association of Dermatologists 1. However, the primary focus should be on addressing the bacterial infection, which is the most common cause of paronychia.

Key steps in treating pus around the nail bed include:

  • Soaking the affected finger in warm water with Epsom salt
  • Applying antibiotic ointment
  • Covering the area with a clean bandage
  • Avoiding picking at or cutting the affected area
  • Considering over-the-counter pain relief medications like ibuprofen or acetaminophen for symptom management

If the infection is severe, with significant pus buildup, redness extending beyond the nail fold, or throbbing pain, seeking medical attention for professional drainage and possible oral antibiotics is necessary, as the infection may require more intensive treatment 1. Preventing future infections involves maintaining good hand hygiene, keeping nails trimmed, avoiding nail biting or cuticle cutting, and wearing gloves for wet work.

From the Research

Pus around Nail Bed Treatment

  • The provided studies do not directly address the treatment of pus around the nail bed.
  • However, some studies discuss the use of antibiotics such as amoxicillin/clavulanate 2, 3, 4, 5 for various infections, which may be relevant in cases where the pus is caused by a bacterial infection.
  • It is essential to note that the treatment of pus around the nail bed typically involves drainage and possibly topical or oral antibiotics, depending on the underlying cause.
  • There is no direct evidence in the provided studies to support a specific treatment for pus around the nail bed.
  • Further research or consultation with a medical professional would be necessary to determine the best course of treatment for this condition.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Oral amoxicillin and amoxicillin-clavulanic acid: properties, indications and usage.

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2020

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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